Reliability of an Italian standardized and expanded Brief Psychiatric Rating Scale (BPRS 4.0) in raters with high vs. low clinical experience

Roncone, Rita; Ventura, Joseph; Impallomeni, M.; Falloon, Ian R. H.; Morosini, Pier Luigi; Chiaravalle, E.; Casacchia, M

doi:10.1111/j.1600-0447.1999.tb10850.x

Cited by 120 publications

(101 citation statements)

References 12 publications

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“…It is a clinician-rated instrument consisting of items assessing symptoms such as somatic concern, anxiety, depression, suicidality, guilt, hostility, elevated mood, grandiosity, suspiciousness, hallucinations, unusual thought content, bizarre behaviour, self-neglect, disorientation, conceptual disorganization, blunted affect, emotional withdrawal, motor retardation, tension, uncooperativeness, excitement, distractibility, motor hyperactivity, mannerisms, and posturing. We used an Italian version of the instrument [78] that has high reliability [79]. The items are scored on a 7-point severity scale.…”

Section: Methodsmentioning

confidence: 99%

Association between Clinician's Subjective Experience during Patient Evaluation and Psychiatric Diagnosis

Pallagrosi

Fonzi²,

Picardi³

et al. 2016

Psychopathology

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Background: Classical psychopathology greatly valued the interaction between clinician and patient, and assigned to the clinician's subjective experience a significant role in the diagnostic process. Psychoanalysis, too, ascribed a privileged position to the clinician's feelings and empathic participation in the assessment and deep understanding of the patient. This study aimed at testing the traditional, though still relatively unexplored empirically, tenet that particular diagnostic groups elicit distinct and diagnostically useful reactions from clinicians. Sampling and Methods: The study was performed in several psychiatric inpatient and outpatient units in Rome, Italy. The clinicians completed the Assessment of Clinician's Subjective Experience (ACSE) questionnaire and other standardized assessment instruments when they evaluated a previously unknown patient. All adult patients diagnosed with schizophrenia (n = 119), cluster B personality disorder (n = 114), manic or mixed bipolar I episode (n = 59), and unipolar depression or anxiety disorder (n = 130) were included in the study, for a total of 422 patients evaluated by 35 clinicians. Results: We found a significant and theoretically consistent relationship between the clinicians' pattern of subjective experience during the first visit and patients' clinical diagnoses. Patients with unipolar depression/anxiety showed significantly lower scores than the other groups on all ACSE scales except engagement; patients with schizophrenia displayed significantly higher scores than the other groups on difficulty in attunement, and significantly higher scores than patients with cluster B personality disorder on impotence. Compared with the other groups, the patients with cluster B personality disorder displayed significantly lower scores on engagement, and significantly higher scores on disconfirmation. In multivariate models controlling for patient's age and education, symptom severity, clinician's sex, duration of visit and setting, diagnosis remained a significant predictor of scores on all ACSE scales except for impotence. Conclusions: The main limitations of the study are its reliance on clinical diagnoses and the non-independence of assessments. Further studies based on diagnoses made by a third observer through standardized instruments are needed to provide a most stringent test of the hypothesis that different diagnoses are associated with distinct profiles of clinicians' subjective experience. This study provided intriguing, though preliminary, evidence that the clinician's subjective experience may play a useful role in the diagnostic process. Time may have come to reintroduce the concept of intersubjectivity at the core of the diagnostic process.

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Section: Methodsmentioning

confidence: 99%

Association between Clinician's Subjective Experience during Patient Evaluation and Psychiatric Diagnosis

Pallagrosi

Fonzi²,

Picardi³

et al. 2016

Psychopathology

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“…All instruments were the official Italian versions [21, 40, 41]. All clinicians involved in the assessments were trained in the correct use of these standardised instruments.…”

Section: Methodsmentioning

confidence: 99%

Subjective Quality of Life: Its Relationship with Clinician-Rated and Patient-Rated Psychopathology

Lasalvia

Ruggeri

Santolini

2002

Psychother Psychosom

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Background: The study compared clinician-rated and patient-rated psychopathology and analysed their relationship with subjective quality of life (QoL) in a sample of patients with a wide range of psychiatric conditions attending a community-based mental health service. Methods: In the context of the South-Verona Outcome Project (SVOP), 139 patients were assessed for both clinician-rated and self-rated psychopathology (by using respectively the Brief Psychiatric Rating Scale and the revised version of the Symptom Checklist 90), and asked to report on their subjective quality of life (by using the Lancashire Quality of Life Profile). In order to explore the associations between psychopathology and subjective QoL bivariate and multivariate analyses were performed. Results: BPRS and SCL-90-R were poorly correlated, both in their total scores and in their various dimension scores. BPRS showed only a modest negative correlation with LQL, which, in contrast, was highly negatively correlated with SCL-90-R. Regression analyses showed that patient-rated psychopathology was the strongest predictor of subjective quality of life, with self-rated depressive symptoms and self-reported paranoid ideation having the highest predictive power. Conclusions: Self-reported psychological distress is more important than clinician-rated symptom severity in predicting subjective QoL. In order to improve QoL, psychiatric treatment should focus not only on simple reduction of symptoms but also on patients’ subjective psychological distress.

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“…(a) The Brief Psychiatric Rating Scale-24 [46,47] in its Italian version [48][49][50]. The symptoms cluster used by Guy et al [51] could not be used, since in our study the 24-item expanded version of the BPRS was used.…”

Section: Psychopathology Measuresmentioning

confidence: 99%

Is Theory of Mind in Schizophrenia More Strongly Associated with Clinical and Social Functioning than with Neurocognitive Deficits?

et al. 2002

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This paper examines the correlations between ‘Theory of Mind’ (ToM) and neurocognitive performance, together with clinical and social functioning, in out-patients with schizophrenic disorders. It was hypothesised that, since the ability to make inferences about the environment and about other peoples’ mental states is a key ingredient of social competence, the assessment of ToM would correlate more strongly with current social functioning than with more traditional neurocognitive measures. ‘Independent raters’ assessed Theory of Mind, neurocognitive and clinical variables as well as community functioning in 44 subjects with schizophrenia. The neuropsychological measures were more closely associated with community functioning than with psychiatric symptoms. These associations remained evident when the effects of intelligence were controlled. Patients with a higher level of competence in making social inferences had better overall community functioning than those who showed less ability in this aspect of social cognition. In a regression model, the capacity to comprehend other people’s mental states (ToM-2) was among the best predictors of global social functioning, together with recent onset of illness, good verbal fluency and low levels of negative and positive symptoms. These results are consistent with other recent findings. ToM measures of social cognition may be a useful addition to neuropsychological assessment when developing programmes for reducing clinical impairments and improving the community functioning of subjects with schizophrenic disorders. Further studies are needed to verify the value of these measures as predictors of the successful application of specific psychosocial rehabilitation strategies.

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Reliability of an Italian standardized and expanded Brief Psychiatric Rating Scale (BPRS 4.0) in raters with high vs. low clinical experience

Abstract: Our results are of particular interest in view of the increasing need to draw upon professionals, other than psychiatrists and psychologists, for cost-effective and standardized evaluation of rehabilitation interventions.

Cited by 120 publications

References 12 publications

Association between Clinician's Subjective Experience during Patient Evaluation and Psychiatric Diagnosis

Association between Clinician's Subjective Experience during Patient Evaluation and Psychiatric Diagnosis

Subjective Quality of Life: Its Relationship with Clinician-Rated and Patient-Rated Psychopathology

Is Theory of Mind in Schizophrenia More Strongly Associated with Clinical and Social Functioning than with Neurocognitive Deficits?

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